Substantial Source of Dosing Error Found for Pediatric Patients

Accurate preparation of small-volume medication doses for pediatric patients may be problematic

MONDAY, Jan. 24 (HealthDay News) -- Current equipment does not permit accurate volume measurements of less than 0.1 mL; consequently there is a substantial risk of dosing error in intravenous medication doses that require small volumes to be administered to pediatric patients, according to a study published online Jan. 24 in CMAJ, the journal of the Canadian Medical Association.

Navjeet Uppal, B.Sc.Pharm., from the Hospital for Sick Children in Toronto, and colleagues used a two-pronged approach to investigate pediatric medication doses. A study of four hypothetical standard pediatric patients evaluated the potential requirements for small volumes of medications based on recommended use. A clinical study of 1,531 pediatric patients admitted to the pediatric intensive care unit (ICU) in 2006 evaluated actual use of small volumes.

The researchers identified 28 common medications that require less than 0.1 mL of available formulation to prepare the dose, according to the hypothetical study. In the clinical study, they found that 7.4 percent of intravenous doses required preparation from less than 0.1 mL of stock solution, and 17.5 percent needed preparations from less than 0.2 mL. For 28.5 percent of the patients admitted to the ICU, at least one dose was prepared from a volume of less than 0.1 mL.

"Our findings indicate a substantial source of dosing error that involved potent medications and affected more than a quarter of the children studied," the authors write.

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